The LCMS and Infertility Ethics. Peter J. Brock

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1 The LCMS and Infertility Ethics Peter J. Brock Introduction This paper responds to the request of LCMS Life Ministries to examine the history of The Lutheran Church Missouri Synod's engagement with ethical issues associated with infertility and what is commonly called reproductive technology and to offer reflections on how the church might proceed in this area for the care of God's people and in witness to the world. The suffering and temptations that come with infertility engage a grand scope of Scripture's witness and the church's theological reflection. We could, and should, say that every proclamation of God's Word, every act of mercy, and every expression of our walking together addresses, in one way or another, some aspect related to infertility and thus our understanding of marriage, family, children, and what it means to be human. The examination that comprises the first part of this paper limits itself to the most specific expressions of the Synod's engagement with infertility ethics over the last 40 years, or approximately since the first child was born as a result of in vitro fertilization. 1 My aim is to bring this examination of our Synod's engagement into conversation with other careful thinkers and apply the contribution of that dialogue in thinking about how the church might proceed. I have organized those thoughts in the second part within the framework of the Synod's emphasis "Witness, Mercy, Life Together." In all of this, I contend that the Lutheran church's engagement with infertility ethics necessarily reveals what we finally believe about God and humanity, and that confession should direct and inform our witness to the world, our mercy to the neighbor, and our life together both as the body of Christ and as fellow human creatures. The thoughts here offered are by no means a final word on these questions. Rather, my hope is that they serve simply as a further call to continue the conversation about infertility, care for couples who suffer, and the promise or threat of reproductive technology. I. LCMS Engagement with Infertility Ethics Our survey begins with four reports of the Commission on Theology and Church Relations of The Lutheran Church Missouri Synod (CTCR). According to the LCMS Constitution and Bylaws, the CTCR assists congregations to "conserve and promote the unity of the true faith, work through its official structure toward fellowship with other Christian church bodies, and provide a united defense against schism, sectarianism, and heresy." 2 The commission also aids congregations "by providing a variety of resources and opportunities for recognizing, promoting, expressing, conserving, and defending their confessional unity in the true faith" 3 and provides "guidance to the Synod in matters of theology and church relations." 4 As such, the reports of the CTCR serve as a sort of voice for the Synod and its engagement with issues such 1 This examination is far from exhaustive, and I have sought to supplement the survey, as well as the paper's second part, with a select bibliography for further reading and reflection Handbook of The Lutheran Church Missouri Synod, Handbook, Handbook, 151.

2 as infertility and the understanding of reproductive technology, though the CTCR is careful to recognize that faithful Christians may disagree with how the commission applies certain biblical principles by which we are all committed to be guided. 5 Much of the information about reproductive technology contained in these reports is, of course, quite dated. Nevertheless, the reports of the CTCR are instructive for how our Synod has publically viewed infertility and reproductive technology and how those views have shifted (or not) over time. Human Sexuality: A Theological Perspective (CTCR Report - September 1981) In September 1981, the CTCR published the report "Human Sexuality: A Theological Perspective." The purpose of this report was three-fold: "1) to place the order of marriage within the larger framework of human sexuality as God's creation; 2) to discuss the purposes or ends which marriage serves, as these are taught in the Scriptures and understood in the history of the church; and 3) to discuss, in the light of these purposes, certain problems or 'issues' which must inevitably engage the attention of those who think about human sexuality." 6 Such a "study of human sexuality from the standpoint of Christian theology," the report notes, "cannot begin with a discussion of marriage. Rather, it must begin with the creation of man as male and female." 7 In a footnote, the report also recognizes that "more could and needs to be said about how our creation as sexual beings affects a whole variety of relationships such as between parents and children..." 8 Grounding its thought in the Lord's creative activity and design, the report notes the implications this order has for understanding human life as created for community, a fellowship of embodied creatures. Though all need not marry, the report nevertheless identifies that "awesome human significance of the encounter between a man and a woman who give themselves fully to each other in a 'one flesh' union of love. The relation between husband and wife has a significance and meaning in and of itself, distinct from any other purposes (such as procreation) which their union may serve." 9 This significance bears witness to important truths of our humanity, including the incompleteness of autonomy overcome by God's creative Word wherein one comes to know oneself only in relation to knowing the other in a fellowship of love. That this reflects humanity's relation to God is not lost on the commission as the report applies the same understanding to procreation within the marriage union, noting that procreation is an actual sharing in God s on-going creative activity a kind of natural promise embedded within the creation: a sign and manifestation of the truth that genuine love is lifegiving and fruitful A willingness to give birth involves a willingness to align ourselves - in wonder, humility, and hope - with that blessing embedded in the order of creation itself. 10 Because of 5 See, for example, CTCR, Christians and Procreative Choices: How Do God's Chosen Choose (September 1996), CTCR. Human Sexuality: A Theological Perspective. A Report of the Commission on Theology and Church Relations of The Lutheran Church Missouri Synod (September 1981), CTCR, Human Sexuality, 6. 8 CTCR, Human Sexuality, 6. 9 CTCR, Human Sexuality, CTCR, Human Sexuality, 17. 2

3 this willingness to align ourselves by faith to God's creative activity, the report concludes that "involuntary childlessness need stand under no special stigma." While couples who are involuntarily childless can find great comfort knowing that the Child Jesus has come among us and that all Christians are members of the one family He has created, nevertheless it is still true that a childless couple may sorrow greatly at their inability to bear children. We need not gloss over that fact. Indeed, we do well to share their sorrow where we can. However, we ought not characterize their union as "incomplete." To do so would be to take back all that was said concerning the relational purposes of marriage. It would be to forget the profound significance of the one-flesh union. That union of husband and wife has a full and sufficient meaning in itself, and the joining of a man and a woman in marriage should not be envisaged merely as a means of reproduction. Furthermore, husband and wife, even when childless, can still engage in a common work. Their union need not turn inward solely upon itself. They can permit the absence of children itself to be creative and fruitful in new ways in their shared life...and, of course, they may seek to adopt children. It would be hard to find anywhere in our lives a more exact paradigm of agape (self-giving love) than the love which will move people to become parents or to provide foster care for those children who for a variety of reasons are without a family to provide for them. 11 Here we do well to note how carefully the CTCR speaks about adoption in the context of infertility. The report describes adoption as an act of self-giving love, moving couples to provide care for children in need. Nowhere does the report suggest that adoption is a treatment for infertility or an answer to the infertile couple's understandable desire to bear children. Before commenting on the report's final section concerning artificial methods of reproduction, it is worth noting that among other reasons the report cites for condemning homosexual activity it includes the truth that the human person is more than mere freedom to define what he or she will be. There are acts or relationships to which we cannot consent without stepping beyond the limitations our Creator has set for His creatures...an unwillingness to make such affirmations is part of a 'flight from creation' which besets the contemporary world and contemporary Christendom. It ought to be resisted in the name of the Redeemer who is also our Creator. 12 These "acts and relationships to which we cannot consent" without rejecting what it means to be human extend beyond homosexual activity, and the CTCR concludes its report by drawing on the whole of the previous discussion to understand and evaluate artificial methods of reproduction. Applying the insight of Lean Kass, the report observes how technology has affected the way in which we view children, cautioning that to make procreation a technical operation, (mere reproduction) and to remove it from the context of mutual love is to deprive individuals of their role as persons in God's creative activities... To sever our acts of procreation from the personal context of mutual love would be to deface the image of God's creativity in our own. 13 Because of this confession, the report warns about the possible pitfalls of artificial insemination. Rejecting the practice of artificial insemination by a donor other than the husband while granting that artificial insemination may be "offered as an aid to procreation within marriage," the CTCR 11 CTCR, Human Sexuality, Emphasis original. 12 CTCR, Human Sexuality, CTCR, Human Sexuality, Citing Leon R. Kass, M.D. Toward a More Natural Science (New York: The Free Press, 1985), 48; and "Making Babies: The New Biology and the 'Old' Morality," The Public Interest 26 (Winter 1972): p

4 still cautions that it may also be a way of avoiding other problems within a marriage rather than addressing them. 14 Furthermore, insofar as artificial insemination is viewed as a treatment for infertility, the report asks what, exactly, this technology treats, identifying the path on which the use of such methods sets us and where that path might lead: [Artificial insemination within marriage] may also be a step - even if a justifiable one - toward an attempt to transform the mystery of human procreation in love into a matter of reproductive technology. We can see this when we note that the procedure does not really accomplish what medicine seeks to do; it does not cure the underlying defect. The physician is, one might say, treating not the defect but the desire of the parents to have a baby. Suppose, however, their desires go further - suppose, for example, they desire a male baby. Is that an end which medicine ought to pursue? We think not. To turn in that direction would be a definite step away from procreation and toward reproduction. 15 Christians and Procreative Choices: How Do God's Chosen Choose? (CTCR Report - September 1996) In September of 1996, the CTCR published another report entitled "Christians and Procreative Choices: How Do God's Chosen Choose?" 16 Expanding on the 1981 report, the 1996 report focuses more on the methodology of moral reasoning. Drawing attention to the importance of learning to ask the right questions, the report offers tentative responses to difficult problems related to infertility and reproductive technology. The commission admits that the questions it addresses are "not easily answered, and they sometimes are so perplexing that they leave Christians in disagreement concerning God's will." 17 Aware of this, the report aims "not simply [at] arriving at one set of answers." 18 Instead, the commission tries to teach thoughtful Christians to "become more practiced and adept at biblically disciplined moral reasoning" with the hope that "we will be able to understand the significance of disagreements,...see how we can continue to reason together concerning God's guidance,...[and] be in a position to take up related questions or new issues..." 19 The report first addresses the issue of surrogacy through artificial insemination by considering a case study involving at least three parties - the husband and sperm donor, his wife with whom the child born would be adopted, and a family friend who would be artificially 14 CTCR, Human Sexuality, CTCR, Human Sexuality, Because the language of choice is questioned later in this paper, along with the idol of autonomy such language worships, it is important to clarify that the CTCR begins this report by noting that Christians' choosing "is shaped, disciplined, and sometimes overruled by God's choice of them through their Baptism into Jesus Christ." Rather than acquiescing to the antibiblical assumptions of our culture, the CTCR seeks in this report to examine "the relationship between Christian faith and practical choices in procreative issues...[reflecting] on how Christian faith and theology inform our ethical choices." We may, in the end, worry that a religious fascination with choosing hides from view the fundamental gift of the gospel (a gift that is cherished rather than chosen), but we should also note that the report itself directs our attention to this question, clearly stating that the Christian "will not be misled by a culture that has carried out to a remarkable degree the Pharisees' vision of autonomous choice." (CTCR, Christians and Procreative Choices, 3, 31) 17 CTCR, Christians and Procreative Choices, CTCR, Christians and Procreative Choices, CTCR, Christians and Procreative Choices, 6. 4

5 inseminated as a nonpaid surrogate. 20 Welcoming the work of Oliver O'Donovan in evaluating how couples respond to infertility, the commission reports that "O'Donovan argues that when reproductive technologies divorce procreation from sexual intimacy in marriage, we risk turning children into projects and products." 21 Instruction on the method of moral reasoning follows, wherein the commission considers "how we might make use of the Small Catechism's discussion of matters relevant to surrogacy and family life" and reminds the reader that "confessional Lutherans are committed to framing questions about surrogacy in [the Small Catechism's] light." 22 The commission concludes its thought on the case study by stating that "the weight of considerations concerning surrogacy is against the plan" to artificially inseminate a nonpaid surrogate with the husband's sperm. The key considerations of the commission in reaching this conclusion are presented in two categories. The first concerns the "practical complexities in family relationships" and the fact that surrogacy will introduce complications that threaten to damage these relationships, which also include how the child is viewed and the relationship to the community before whom this would unfold. The second category concerns faith in God that follows His "guidance about marriage and family." Citing the CTCR's 1981 report that described God's intention for conception to take place within the one-flesh union of husband and wife, the commission concludes that the current case study would disturb that union by introducing a third party into the conception of a child. 23 Even though in vitro fertilization using gametes from the married couple with a surrogate might be used in an attempt to preserve the one-flesh union, the commission maintains "the implantation of the embryo and the gestation of the child in another woman's womb continue to locate some of the most intimate features of marital and parental relationships outside the one-flesh union of husband and wife." 24 The second case study the commission considers involves artificial insemination by donor, used by a married couple because the husband is sterile. Unique considerations mentioned in this case begin with concern about reducing the "donor's role simply to that of providing the initial genetic material," a proposal that troubles the commission on Scriptural grounds by minimizing the role of fatherhood in relation to children. 25 The report also considers the "psychological and emotional risks" both for the couple and for the child in concluding that "the weight of considerations thus comes down against the practice of artificial insemination by donor... [and] the considerations that lead to a rejection of artificial insemination by donor apply equally to human egg and embryo donation." 26 A third case study in this report considers a couple deliberately and voluntarily choosing not to conceive a child in marriage. Allowing for rare and truly exceptional circumstances, the commission puts forward the thesis that "both God's Word and practical considerations that arise counsel against voluntarily choosing not to conceive a child in marriage." The following biblical 20 Though not often counted in these considerations about "third party" reproduction, the child conceived takes the number of persons involved to four. 21 CTCR, Christians and Procreative Choices, CTCR, Christians and Procreative Choices, CTCR, Christians and Procreative Choices, CTCR, Christians and Procreative Choices, CTCR, Christians and Procreative Choices, CTCR, Christians and Procreative Choices, 22. Emphasis mine. 5

6 reasons support this thesis: 1) "God's Word rejects making marriage a function of indefinite and inconstant human choices;" 2) "a child 'makes physical and represents in the flesh' the unique relationship of a man and woman who come together sexually;" and 3) "the creation narrative explicitly links the creation of man and woman with God's command to be fruitful and multiply." 27 The practical observations that support the commission's thesis include the strong link between marriage and parenting, and the report laments "one of the most persistent and pernicious lines of attack on God's guidance concerning marriage...the one that seeks to separate the relationship of husband and wife from the relationship of parents and children...the unity of the family is then fractured - the union of husband and wife and the relationship of parents and children, contrary to God's intent, are both severed." 28 These observations attend also to questions surrounding infertility, for, the report continues, "however strongly we share the sorrow of infertile couples, we are all cautioned against consciously choosing to separate the conception of children from the one-flesh union of marriage" as is done by "third party intrusion into procreation" just as much as by couples who voluntarily choose to be childless. When considering the church's witness to the world, which includes very public witness about contemporary issues such as homosexuality and marriage, we should observe carefully where certain assumptions lead. Should we assume that "being a parent has little to do with the one-flesh union of the child's father and mother," as many arguments in favor of assisted reproduction do, we may suddenly find it difficult to disagree with others who share this assumption. 29 Among those who share this assumption the report lists two women who "compact together to have a child by contriving to arrange for one of them to become pregnant; two men...[who] arrange for a surrogate to carry the child that they think they have a right to parent in their own way; and single women and single men [who] decide purposely to bring a child into existence through the use of artificial insemination or surrogacy." 30 Moreover, the report observes, "once the nature of the union of husband and wife is made a separate question from that of the relationship of parents and children, then the essence of marriage can be significantly obscured." 31 Marriage may be seen as a tenuous contract of convenience or companionship, easy to dissolve when circumstances change. God's Word becomes difficult to trust, for "when sexual intimacy and parenting in this way become separate issues," the commission worries that "people also begin to doubt God's guidance concerning lifelong commitment in marriage." 32 On a separate but related note, this obscuration of marriage's essence begins, I think, to identify the tension and conflict that so often arise in a marriage when children are absent. "When Rachel saw that she bore Jacob no children," Genesis 30 records, "she envied her sister. She said to Jacob, 'Give me children, or I shall die!' Jacob's anger was kindled against Rachel, and he said, 'Am I in the place of God, who has withheld from you the fruit of the womb?'" 33 The 27 CTCR, Christians and Procreative Choices, CTCR, Christians and Procreative Choices, CTCR, Christians and Procreative Choices, CTCR, Christians and Procreative Choices, CTCR, Christians and Procreative Choices, CTCR, Christians and Procreative Choices, Gen 30:1-2. (ESV) Emphasis mine. 6

7 envy and anger prowling near infertility's door should not be overlooked as the church considers how to care for today's Rachels and Jacobs. The report also responds to claims that "procreative choices are simply a variation on the morally praiseworthy practice of adoption," contending that welcoming an adopted child into the one-flesh unity of marriage correlates to assisted reproduction involving third parties. 34 Reiterating respect for the one-flesh union of marriage in procreation, the commission makes the rather casual observation that "the practice of adoption does not involve a choice to conceive a child outside of the one-flesh relationship of marriage." 35 Indeed, the report describes the direction of adoption's aim as quite the opposite. Rather than choosing in favor of a couples' desire adoption has the child's well-being in view, responding "to the absence or disruption of a family context in a child's life by welcoming the already present child into a new home." 36 As in the 1981 report, the CTCR does not suggest adoption as a cure for the couple's desire. Quite the opposite, the commission mentions adoption as a response to the child's needs, adding that adoption "is one way for some infertile couples to serve God and the world by responding to the needs of a child through parenting." 37 In the report's fourth and final case study, the CTCR considers in vitro fertilization. Although this report marks the first time the synod has responded directly to in vitro technology, the commission recalls that synodical representatives contributed to the 1985 report by the Division of Theological Studies of the Lutheran Council of the U.S.A. Those LCMS representatives suggested at that time that any use of in vitro technology should be limited to the sperm and egg of a husband and wife without the use of a surrogate. Additionally, the LCMS representatives insisted that all embryos must be implanted in the wife, precluding any experimentation, destruction, or storage of "unneeded or defective fertilized eggs" and rejecting any termination of an IVF pregnancy "other than to prevent the death of the mother." 38 Because of common practices associated with in vitro fertilization, to which the limitations just mentioned sought to respond, the commission expresses concern that "in vitro fertilization is such a complete technological intrusion into the mystery of the creation of new human beings that use of this technology may inevitably lead to practices no Christian could affirm." 39 Though troubled "about potential for abuse opened up by this technology," the 34 CTCR, Christians and Procreative Choices, CTCR, Christians and Procreative Choices, CTCR, Christians and Procreative Choices, CTCR, Christians and Procreative Choices, CTCR, Christians and Procreative Choices, 36-37: "Because the biblical injunction to be fruitful and multiply was given by God to a man and a woman united in the one-flesh union of marriage (Gen. 1:28; 2:21 25), only the sperm and egg of a man and woman united in marriage may be employed. Any use of donor sperm or eggs involves the intrusion of a third party into this one-flesh union and is contrary to the will of God. For the same reason surrogate wombs must not be used. Because the unborn are persons in God s sight from the time of conception (Job 10:9 11; Ps. 41:5; 139:13 17; Jer. 1:5; Luke 1:41 44), all fertilized eggs must be returned to the womb of the woman. Any experimentation with, destruction of, or storage of unneeded or defective fertilized eggs fails to accord respect and reverence for new life brought into being by God at the moment of conception and is contrary to his will. The same considerations preclude any agreement to permit the interruption of an IVF pregnancy for any reason other than to prevent the death of the mother." 39 CTCR, Christians and Procreative Choices, 37. 7

8 commission explains that it is "reluctant to locate the problems that arise simply in the medical technique itself and to suggest that Christians could never faithfully use it." 40 Still, the CTCR concurs with the 1985 synodical representatives that if in vitro fertilization is able to be used faithfully, it "will involve sperm and eggs only from within the marriage" and that surrogacy raises troubling questions "regarding the implications...for the oneflesh union of a married couple." 41 Regarding the care and fate of embryos made through in vitro technology, the commission recognizes that "these arguments deserve careful attention because they raise questions about the status of the unborn from the time of conception" and that "respect for the unborn at every stage can be enhanced also by reflection on the biblical themes concerning marriage and procreation." 42 The report mentions four themes in response to fertilizing more eggs than are intended for implantation, genetic screening prior to implantation, attempts to see an analogous relationship between in vitro and in vivo loss of embryos in attempts to conceive, and selective reduction of implanted fetuses: 1) Because human dignity and worth are received as gifts from God rather than calculated on the basis of capacity, choosing not to nurture an embryo signifies rejecting a gift of God; 2) God often acts in ways that we are not given to act, and that which the Lord permits does not enable us to aim at the separation of what God has joined, destroy a relationship God has created or exclude a life the Lord has given, even when that "life seems problematic to us;" 3) Welcoming medical science that cures and cares does not commit us to "technologies that cut embryonic lives short in the name of caring, regardless as to whether the care is for couples thought to be infertile or for embryos affected be genetic disease; and 4) Because of the intimate relationship between procreation and the one-flesh union of marriage, denying embryos "nurture in the womb that God created to receive them" risks distorting and diminishing "the unique and sacred expression in the embryo of the one-flesh union of marriage." CTCR, Christians and Procreative Choices, CTCR, Christians and Procreative Choices, CTCR, Christians and Procreative Choices, CTCR, Christians and Procreative Choices, 39. "First, in the biblical perspective the dignity and worth of the members of a family are not based on their inherent genetic properties or developed talents. Instead, God gives us to one another and commends us to mutual care for each other. One s spouse is loved as that person to whom one has been joined by God. One s children are received as gifts from the same God. One s parents are honored because God has placed them in that role. A conscious decision not to nurture an embryo procreated from within a marriage is tantamount to a decision not to nurture a gift given by God. Such a decision would seem to encourage the notion that familial relationships are conditioned primarily on human choice rather than on God s gifts. Second, God does and permits many things that we are not permitted to do. God permits marriages to end through untimely illness or accident. Sometimes illness or accident take a young child from loving parents. In the mystery of the beginnings of life God does in fact permit natural causes to end pregnancies. None of these events yet establishes that spouses are to separate what God has joined, or that parents or children are permitted to end their human relationship, or that we may consciously choose to exclude from the womb an embryo or fetus whose life seems problematic to us. Third, we are sympathetic to the argument that the church should welcome medical technology that expands our ability to cure and to care. But we do not see how this commits us to technologies that cut embryonic lives short in the name of caring, regardless as to whether the care is for couples thought to be infertile or for embryos affected by genetic disease. In our culture of death Christians must be alert to and must reject arguments purporting to show that actively ending a human life is the best way to express our care for one another. Fourth, we believe that the biblical witness puts the highest premium on the institution of marriage and on the closely related mystery of procreation within this one-flesh union. When embryos explicitly created from within a marriage are denied the possibility of 8

9 The CTCR summarizes these themes by stating that Christians who recognize Scripture's witness regarding unborn children and marriage will likewise recognize limitations to the practice of in vitro fertilization along with the temptation it brings "to act without trusting God and to pursue goals the world holds before us without sufficient attention to God's Word." 44 In conclusion, the CTCR acknowledges that "the future portends rapid change and development in both technology and society concerning marriage, family, and procreation," and the commission therefore prays that "the Lord of the church will keep his people faithful to his will as we greet and reflect on each new choice presented to us." 45 What Child Is This? Marriage, Family and Human Cloning (CTCR Report - April 2002) Five years after the announcement of the first cloned mammal (Dolly the sheep) and five months after American researchers claimed to have cloned the first human embryos, the CTCR published its report What Child Is This? Marriage, Family and Human Cloning. 46 In this report nurture in the womb that God created to receive them, then the unique and sacred expression in the embryo of the one-flesh union of marriage is subject to distortion and diminution." 44 Christians and Procreative Choices, CTCR, Christians and Procreative Choices, 40. I think it is worth noting that the report concludes all but the last case study with a section labeled "Disagreement?" "Not all Christians will agree with the conclusions to which the Commission came," the report acknowledges before asking, "What is the significance of disagreements that may arise on issues like this within The Lutheran Church-Missouri Synod?" The observations of the commission which respond to this question are: "1. We are together pledged not to disagree on our basic strategies for approaching difficult ethical questions. For example, we are pledged to give God s Word the central place in our deliberations, and we are agreed that Lutheran confessional documents such as the Small Catechism are reliable guides for finding our way in the Scriptures. Walking together in our Synod means that we together agree on the key resources available for Christian guidance. We also agree to pray together in the midst of our deliberations. We together trust that the Holy Spirit will strengthen our faith. 2. Ethical reasoning often includes reflection on somewhat unpredictable aspects of human life. In the case of surrogacy, for example, we reflect on possible emotional and psychological implications for the parents and children who are involved. Judgments concerning such implications often leave room for honest disagreement among Christians. For example, not everyone will agree with Oliver O Donovan that surrogacy and other reproductive technologies lead people to view a child more as a project or product than as a unique human being. We may find ourselves disagreeing about the risks involved in a relatively rare arrangement such as surrogacy. Insofar as our reasoning turns on the assessment of such risks we may find ourselves disagreeing about the acceptability of surrogacy. 3. In its discussion of surrogacy the Commission put special weight on its 1981 conclusion that the proper context for the conception and gestation of a child is the oneflesh union of husband and wife. Faithful Christians will not disagree with the commitment to be guided by God s Word. Some may, however, disagree with how the Commission has applied the scriptural one-flesh principle to the question of bringing a child into the world. The Commission s own words in the 1981 document leave some room for considered disagreement: Although the Scriptures do not deal directly with the subject of artificial insemination by a donor other than the husband (AID), it is our opinion that such a practice must be evaluated negatively. the process of fertilization is removed from the personal context of the one-flesh union of husband and wife in a way that not even their consent can allow. In our synodical life together there are a variety of ways for responsible pastors and congregations to communicate and work through disagreements concerning how God s Word speaks to complicated contemporary issues" (18-19). The commission offers the report itself as a resource for congregations to discuss how God's Word and the Christian faith relate to the difficult questions of procreative ethics and assisted reproduction. 46 The report begins with a call to patience. Citing G.K. Chesterton, who saw in 1933 that "private theories about what the Bible ought to mean, and premature theories about what the world ought to mean, have met in loud and 9

10 the commission introduces several considerations important to the present conversation about infertility and reproductive technology, among which is the commission s aim "to make a contribution to the ability of Christians to discern when to celebrate emerging gifts and when to witness against looming evils." 47 Also helpful for our present purposes, the commission introduces the significance of personhood and human dignity to the conversation. Though speaking specifically to the question of origin when discerning personhood, we can nevertheless extrapolate the commission's conclusion that personal dignity belongs to each human, regardless of origin, simply because such a one is human. Certainly this personal dignity belongs to each parent as much as to the child. It belongs no less, then, to a husband and wife who lack the capacity to conceive. 48 Expanding on this significance, the report observes from Scripture that because Christ has come, "we are now called to be children of God, persons drawn into the life of the Holy Trinity and thus finally beyond the reach of the futility of life toward death." 49 Marriage, the commission reminds, provides "a fundamental created setting in which God desires to transform children of the flesh - both parents and children - into children of God." 50 Therefore, Fathers and mothers and their children are to learn to see each other not as objects and resources for fulfilling their goals in life, but as persons given to each other by God to be loved as God loves...marriage is understood biblically as a relationship in which wife and husband, parents and children, are challenged to live by faith in God rather than by confidence in their own abilities to protect themselves from their vulnerabilities to each other. This means that for Christians marriage and family press beyond themselves to a reality that transcends this life. Marriage has roots in our biological and flesh-oriented existence, but it images a richer spiritual reality - the community of persons born of the Spirit...Marriage is thus a created image and analogy of relationships in the church, the Body of Christ. Our principle then is that marriage is to be held in the highest regard as the context in which children born of the flesh are best brought into the world. Marriage is the context where wife, husband and children may perhaps find, as one of the church's prayers says, "a foretaste of our eternal home." It is in this light that we consider how Christians enter sexual relationships and how they understand themselves as parents. 51 The implications of the report's principle that marriage, family and children teach us what it means to be human surely include that we should beware any activity that would lead us to unlearn the lessons that marriage, family and children teach. "From this perspective," the commission hopes, "we will also be able to provide wisdom to the world at large, though we will not expect that persons who choose to continue living life only in the flesh will necessarily be persuaded by a vision that calls them to repentance and new life in the Spirit." 52 Rather than widely advertised controversy." Chesterton calls that controversy a "clumsy collision of two very impatient forms of ignorance...known as the quarrel of Science and Religion." The report wants no part in any clumsy collision, insisting instead on "patience both to discover the genuine promises and to recognize the real threats that arise in modern science's study of genetics and cloning. (CTCR, What Child Is This? Marriage, Family and Human Cloning. A Report of the Commission on Theology and Church Relations of The Lutheran Church Missouri Synod [April 2002), 5. G.K. Chesterton. St. Thomas Aquinas [New York: Sheed & Ward, 1933], 98.) 47 CTCR, What Child Is This?, For a helpful discussion on personal dignity, see Gilbert Meilaender, Neither Beast nor God: The Dignity of the Human Person (New York: Encounter, 2009). 49 CTCR, What Child Is This?, CTCR, What Child Is This?, CTCR, What Child Is This?, CTCR, What Child Is This?,

11 despairing over the Christian vision's perceived persuasiveness, which inevitably leads to that panic which departs from Scripture's vision, the church is given patient faith that sees wisdom in the cross and suffering the world calls folly, and the works that incarnate that faith bear witness to the world of the reality that transcends this fallen life. Thus, the "no" the church may wish to speak to certain exercises of human freedom, proclaims a resounding "yes" in Christ to the neighbor precisely because the world finds it peculiar. Another insight offered by this report that contributes to our conversation about infertility is the commission's observation that even in marriage procreative potential can become the temptation "to add one more selfish project to [the couple's] list of accomplishments...not an opportunity for love but one more occasion for engineering our own self-fulfillment." 53 God's design for procreation, the one-flesh union of a husband and wife who are significantly "other" and, we might add, whose act of love in sexual intercourse draws them outside of themselves and their plans, reminds the couple that any fruit of their union is also a unique "other" who can only then be received as a gift that bears no obligation to fulfill the parents' projects or goals. 54 Applying this perspective to reproductive technologies described by the report as "developed primarily to help rectify problems of infertility in marriage," the commission includes the following evaluations: 1) artificial insemination introducing the husband's sperm into the body of his wife "is considered a possible approach to overcoming infertility" while artificial insemination by donor is "an inappropriate remedy for infertility;" 2) "surrogacy is discouraged;" 3) in vitro fertilization using the sperm and eggs of husband and wife "does not seem to be a disturbance of the marital relationship and the relationship between the parents and the child" though when in vitro fertilization uses sperm and/or egg donors "the violation of the purposes of marriage seems once again to occur;" and 4) "cloning human beings is a fundamental assault on the created order of God." 55 Finally, as with the two previous reports considered, the CTCR again responds to proposed analogies to adoption, this time describing how adoption relates to the question of genetic origin. Since the accepted practice of adoption means welcoming a child who originates outside of the one-flesh union of husband and wife, some wonder why the church would reject reproductive methods that use gametes originating outside the marriage. Again, the commission reorients the focus of adoption as compared to reproductive technology. "In adoption," the report explains, "a couple typically is rescuing a child who lacks a family, rather than purposely creating a child in a way that goes beyond the marriage." 56 Additionally, while some would argue that the analogy of our adoption by God in Christ suggests a less limited perspective regarding the union of sperm and egg of husband and wife, the commission insists that the "biblical analogy of adoption suggests most persuasively the opposite. Couples who are not so focused on reproducing some of their own DNA are likely to be more prepared to share their love with the world in whatever way God calls them." 57 The CTCR also includes a footnote to 53 What Child Is This?, See Gilbert Meilaender, "Procreation versus Reproduction" in Bioethics: A Primer for Christians (Grand Rapids: Eeerdmans, 2013), CTCR, What Child Is This?, CTCR, What Child Is This?, CTCR, What Child Is This?,

12 their comments on adoption, noting that the commission considers embryo adoption "to be similar to regular adoption and therefore morally permissible," adding that "just as we can approve and recommend regular adoption, so we can recommend and approve embryo adoption." 58 Concluding their report, the CTCR reminds the church that in order for Christians "to recognize the grave moral dangers inherent in the practice of cloning they will need to reflect carefully on the use of contraception and reproductive technologies." 59 Finally, the commission explains, as the church engages "in this task of assessing contemporary technologies of reproduction, our foremost concern is to ask what these technologies mean in light of Christ's promise of new birth from above through water and the Spirit." 60 Christian Faith and Human Beginnings: Christian Care and Pre-implantation Human Life (CTCR Report - September 2005) The fourth and final CTCR report taken up here is the 2005 publication Christian Faith and Human Beginnings: Christian Care and Pre-implantation Human Life. The commission explains its goals for this report as helping people move toward consensus on questions about pre-implantation human life and finding ways to articulate the pro-life position and its strategies that will lead to progress in the context of the political realities of our pluralized society. 61 The CTCR recalls how in 1984 O'Donovan identified the moral problems introduced by in vitro technology, suggesting the most prudent response would be "to abandon IVF so we are no longer presented with the profoundly troubling ambiguity." 62 O'Donovan's counsel, of course, was not heeded, and the commission's report concedes that "we cannot escape pondering the significance of human life presented to us in Petri dishes in an IVF clinic...upon examination, the Commission on Theology and Church Relations has remained convinced that both biblical and philosophical perspectives support the wisdom of protecting pre-implantation embryos from the time of conception." 63 To support this conviction, the commission further develops the significance of personhood, a consideration introduced in the CTCR's 2002 report What Child Is This? Citing O'Donovan's book, Begotten or Made? the report connects the idea of personhood to what the church fathers wrote about the Trinity and the two natures of Christ. Based on the early church's discussion, O'Donovan understands that "a person is a substance, and a nature is the 'specific' property of a substance; it is not the case (as supposed by heretics on all sides) that to every nature there corresponds a person. In other words, the distinctive qualities of humanity are 58 CTCR, What Child Is This?, CTCR, What Child Is This?, CTCR, What Child Is This?, CTCR, Christian Faith and Human Beginnings, CTCR, Christian Faith and Human Beginnings, CTCR, Christian Faith and Human Beginnings,

13 attributable to persons, not persons to the qualities of humanity." 64 On this basis, in part, O'Donovan argues for the "full moral/spiritual status of pre-implantation human life." 65 Worth noting is the report's observation that "O'Donovan also seems to want to argue that the ultimate decision [regarding the status of pre-implantation human life] must be made on grounds other than science." 66 "We discern persons only by love," O'Donovan writes, "by discovering through interaction and commitment that this human being is irreplaceable." 67 According to O'Donovan, the wrong in destroying pre-implantation human life should not be the old-fashioned crime of killing babies, but the new and subtle crime of making babies to be ambiguously human, of presenting to us members of our own species who are doubtfully proper objects of compassion and love...when we start making human beings [in IVF] we necessarily stop loving them; that which is made rather than begotten becomes something that we have at our disposal, not someone with whom we can engage in brotherly fellowship...there is no road which leads us from observation first to fellowship second, only a road which leads us from fellowship first to discernment second...unless we approach new human beings, including those whose humanity is ambiguous and uncertain to us, with the expectancy and hope that we shall discern how God has called them out of nothing into personal being, then I do not see how we shall ever learn to love another human being at all. 68 The commission concludes that O'Donovan's approach is helpful for understanding personhood on the basis of the Trinity and Christ's two natures, demonstrating that more is at stake than the Fifth Commandment alone. The CTCR's report commends further reflection on this approach, suggesting that it will "carry the discussion beyond an exclusive focus on an isolated individual's 'right to life'... into a consideration of the meaning of human fellowship with God and with one another." Oliver O'Donovan. Begotten or Made? (Oxford: Oxford University Press, 1984), 54. Cited in Christian Faith and Human Beginnings, CTCR, Christian Faith and Human Beginnings, CTCR, Christian Faith and Human Beginnings, 27. Also helpful is the essay of C.S. Lewis, "Christian Apologetics": "We have to answer the current scientific attitude towards Christianity, not the attitude which scientists adopted one hundred years ago. Science is in continual change and we must try to keep abreast of it. For the same reason, we must be very cautious of snatching at any scientific theory which, for the moment, seems to be in our favour. We may mention such things; but we must mention them lightly and without claiming that they are more than interesting. Sentences beginning Science has now proved should be avoided. If we try to base our apologetic on some recent development in science, we shall usually find that just as we have put the finishing touches to our argument science has changed its mind and quietly withdrawn the theory we have been using as our foundation stone" (C.S. Lewis, "Christian Apologetics," in God in the Dock: Essays on Theology and Ethics, ed. Walter Hooper [Grand Rapids: William B. Eerdmans, 1970], 92). See also Francis Pieper, Christian Dogmatics vol. I: "We are certain that there cannot be or ever is a real contradiction between Christian theology and true science, science in abstracto. But we are equally certain that it is not nor can it be the task of a theologian to reconcile our Biblical theology and science in concreto. The charge is indeed valid that in our efforts to lead the present unbelieving generation back to faith we make no attempt to demonstrate to the world the harmony of faith with science. But we see no reproach in this charge; rather, we glory in it, and we will not, by the grace of God, permit anyone ever to rob us of this glorying. For we are very certain that it is not possible to help the present apostate world with the lie that the divinely revealed truth is in perfect accord with the wisdom of this world; only the preaching of the divine foolishness, of the old unadulterated Gospel, can help the world (Francis Pieper, Christian Dogmatics, vol. 1 (St. Louis: Concordia, 1950), Oliver O'Donovan. Begotten or Made?, Oliver O'Donovan. Begotten or Made?, Cited in Christian Faith and Human Beginnings, CTCR, Christian Faith and Human Beginnings,

14 The report continues with an extended discussion of the biblical witness concerning preimplantation human life and the scientific and philosophical perspectives surrounding its protection. Among the commission's conclusions, the report is adamant that "we can and must pray and hope that God will guide our society, both Christian and non-christian, toward consensus on moral truth concerning pre-implantation human life. Meanwhile, because God has entrusted His church with the clear message of reconciliation centered in Jesus Christ through whom God has reconciled us to Himself (2 Cor. 5:19), we dare not let societal disagreement on a moral and political question cause us to lose our focus on the Gospel-centered mission of the church." 70 Nevertheless, the respect for and protection of human life for which the commission calls means renouncing the destruction of embryos for research. The commission also urges "couples and their medical advisers to aim toward the practice of transferring all embryos" created through IVF, adding that "the practice of freezing embryos for future attempts at pregnancy can be a life-affirming practice...we consider that respect for human life can also be expressed by making embryos available for adoption by couples willing to provide the opportunity for life." 71 Recalling the 1996 report's conclusion that "considerations that lead to a rejection of artificial insemination by donor apply equally to human egg and embryo donation," we might begin to see a distinction, at least for the church and discussed further below, between embryo donation and embryo adoption. 72 That is, we might understand from these reports that the CTCR discourages the practice of embryo donation, defined here for the purpose of this distinction as the creation of embryos through IVF with the intention or even potential that they be implanted in the womb of someone other than the biological mother. On the other hand, the commission seems to suggest that embryo adoption may be a moral option for the sake of rescuing embryos that already exist. Either way, we will need to attend more closely below to the question of freezing embryos and its description as a "life-affirming practice." In closing, the commission urges Christians to "familiarize themselves with the current and changing state of debate concerning embryonic stem cell research." Thus informed, Christians are encouraged to embrace the "opportunity and responsibility to participate in the political processes" that affect attitudes and actions toward pre-implantation human life. 73 Other LCMS Writers Several other LCMS writers have significantly contributed to The Lutheran Church - Missouri Synod's engagement with infertility ethics and reproductive technologies. 74 In Holy People Holy Lives: Law and Gospel in Bioethics, Richard C. Eyer offers a straightforward 70 CTCR, Christian Faith and Human Beginnings, CTCR, Christian Faith and Human Beginnings, CTCR, Christians and Procreative Choices, CTCR, Christian Faith and Human Beginnings, Again, this survey is far from exhaustive. See the select bibliography for other LCMS writers and resources that have responded to infertility and reproductive technology. 14